- Home
- Informtion
- Doctors inform
- Gynecologist informs
- Rational nutrition during pregnancy
- Home
- Informtion
- Doctors inform
- Gynecologist informs
- Rational nutrition during pregnancy
Rational nutrition during pregnancy
25.06.2024
Rational nutrition during pregnancy
Meals by trimester.
Proper nutrition of the expectant mother is a necessary condition for the normal course of pregnancy, growth and development of the fetus. And although at all times it has been extremely difficult to provide pregnant women with a variety of nutritious nutrition, compliance with some basic provisions is still necessary. However, a pregnant woman’s nutritional needs do not change suddenly; they depend on the duration and characteristics of the pregnancy.
We increase the caloric content of the diet.
So in the first trimester of pregnancy there is no point in increasing the calorie intake; a tiny embryo is quite sufficient with normal nutrition; after 12 weeks, at least 2400 and no more than 2600 kcal per day is needed. In the second half of pregnancy, these numbers increase: the lower limit of food calories is now 2800 kcal, and the upper limit rises to 3000 kcal. Women carrying twins should increase their diet by another 150 kcal/day. Also, increased caloric intake is required by mothers whose interval between pregnancies is very short or pregnancy occurred while breastfeeding, and by pregnant adolescents to meet the demands of the continued growth of the mother's body.
All the figures given are approximate; in addition to them, one must also take into account the body mass index at the time of pregnancy.
Body mass index = body weight in kg / height in meters squared
Example: Height 1.70 m, weight 60 kg BMI= 60/1.7*1.7=20.7
If you are underweight (BMI < 18.5), your caloric intake may exceed the above values, and if you are obese (BMI > 30), your calorie intake may be less than this, as recommended by your healthcare professional.
However, proper nutrition is not so much about quantity as it is about the quality of food.
First trimester.
As already mentioned, up to 12 weeks is quite a bit to ensure the growth of a little man. Therefore, the feeling of hunger that a woman may experience during this period cannot be “suppressed” by double lunches and dinners. It is necessary that the diet be varied and contain the required amount of proteins, fats, carbohydrates, minerals and vitamins. In the first half of pregnancy, it is better to eat 4 to 5 times a day, if possible, at the same time. Breakfast should be 30% of the daily calorie content, lunch - 40%, afternoon snack - 10%, dinner - 20%, that is, in the afternoon the food load decreases.
It is imperative to ensure that the food is fresh, and it is also recommended to drink more. It is known that the human body is 80% liquid. Modern research shows that for the normal course of pregnancy you should not limit yourself to fluids, even with edema. Until 20 weeks, drinking should be plentiful and healthy (up to 2 liters per day). Water is needed to improve metabolism, good bowel function, normal absorption of medications, good health, maintaining normal blood pressure, and adequate sleep.
Pure water has been and remains the best source of liquid for humans - it quenches thirst best, has a beneficial effect on kidney function, is retained less in the body compared to any solution, and has no contraindications or side effects. Drink water only in bottles to avoid all kinds of bacteria and viruses entering the body, preferably slightly mineralized (mineralization level 1-2 g/l), non-carbonated.
Not all liquids are healthy. For example, coffee, cocoa, and tea contain caffeine, which increases blood pressure and removes fluid from the body, and a cup of strong, freshly brewed tea contains no less caffeine than the same cup of coffee. Just like green tea, which has a deceptively light color associated with lower strength, it also contains no less caffeine. Despite the fact that caffeine is dangerous only in large quantities, it should be treated with caution. A pregnant woman suffering from low blood pressure can easily afford one or two small cups of coffee or tea a day, but remember that for every cup of coffee you drink, you should drink a few extra cups of water.
The amount of table salt should not exceed 8-10 g per day. Table salt is necessary to maintain a certain salt composition of the blood and osmotic pressure. Simply put, one molecule of salt is always followed by two molecules of water. It is salt that causes fluid retention in the body, swelling and thirst. Excessive salt intake in early pregnancy can trigger early pregnancy toxicosis (nausea and vomiting).
For the proper development of fetal organs and systems, a sufficient amount of vitamins and minerals is necessary. To get enough vitamins and minerals, you need to eat raw vegetables, berries and fruits. Both well-washed raw and heat-treated. They are sources of vital substances, and in addition, they will not allow you to gain much weight. A real treasure for a pregnant woman is a salad of fresh vegetables, seasoned with vegetable oil (for better absorption of fat-soluble vitamins). When cooking vegetables, up to 25% of minerals are lost into the water, so it is better to eat boiled vegetables in the form of soups.
However, not only a deficiency, but also an excess of vitamins is harmful. For example, excessive intake of vitamin A can cause birth defects in a child. Therefore, before taking any vitamin supplements, be sure to consult your doctor. A prerequisite for the safety of using multivitamins during pregnancy is the use of specially designed complexes for pregnant and lactating women. Multivitamins for pregnant women contain a preventive dose of all components. They are designed as a supplement and not as a meal replacement, so there is no reason to worry about overdosing.
The most common complication of the first trimester of pregnancy is the development of early toxicosis. If you are concerned about nausea and vomiting, it is advisable to reduce the size of portions by increasing the frequency of meals; After each meal you should lie down for a while. Water cannot be limited; drinking plenty of water up to 2 liters per day eases the course of toxicosis.
It is necessary to carefully follow the cooking technology: wash vegetables and fruits well, cook meat until cooked, avoid eating raw meat. The habit of tasting minced meat can cause infection with toxoplasmosis, a disease dangerous to the development of the fetus. Chilled raw and smoked fish, raw oysters, shellfish, and sushi may contain the causative agent of listeriosis, the consequences of which may be miscarriage and impaired fetal development.
Pregnant women suffering from toxicosis often experience a decrease in appetite, and sometimes an aversion to certain types of food, such as meat and fish. The reason for the changes in taste is progesterone, a hormone produced by the ovaries and placenta to maintain pregnancy. It is this hormone that triggers the search for one or another deficiency in the mother’s body and builds a program to eliminate this deficiency. So, if there is a lack of calcium, there is a desire to chew chalk or plaster, of folic acid - to chew green leaves, of B vitamins - to drink beer. If your preferences relate to those products that will not harm the child, then please, you can indulge in them with pleasure. If you’re craving something “harmful,” then try to replace it with something: candy with cereal bars, soda with sour juices, pickles and marinades with crackers. In addition, this mechanism breaks down when there is a severe deficiency of any substance.
The expectant mother needs to minimize the consumption of genetically modified products, chemically processed, containing all kinds of dyes, additives, stabilizers, thickeners and preservatives. Ideally, you should exclude them completely, but this is almost impossible to do in the modern world - so try to eat as environmentally friendly products as possible. Exotic products should be treated with caution.
Second trimester.
In the second trimester, the main formation of organs and systems took place, and now they are actively growing and developing. All this needs building material to build new cells and tissues. The main building material is protein. During pregnancy, it is necessary that 50% of the total amount of proteins entering the body be of animal origin, that is, those found in fish, meat, milk, dairy products, and eggs. The remaining half of the proteins can be of plant origin (beans, soybeans, peas). The daily diet of the expectant mother should contain at least 100 grams of meat (including poultry) and fish, milk and dairy products, cheese, cottage cheese, eggs. According to scientists, those babies whose mothers receive a sufficient amount of protein from food during pregnancy have better growth and development indicators in the first years of life.
Vegetarian diets are becoming more and more common, but if you only eat vegetables and fruits, don't think you're doing your body a favor. Well-balanced vegetarian diets must include dairy products, seafood, and eggs. It is no coincidence that even during Lent the church makes an exception for pregnant women and allows them to eat meat, milk, eggs and other foods containing protein. Vegetarians, as a rule, fail to obtain sufficient amounts of protein and iron from food, which are necessary for the construction of hemoglobin.
Hemoglobin in the human body performs the function of transporting oxygen, delivering it to the fetus. It is known that the expectant mother needs additional sources of dietary iron. However, well-known people's favorites - beets, pomegranates and apples - are by no means the best source of iron. The thing is that iron in food is present in two forms: heme (its chemical formula is a protein ring associated with an iron atom) and non-heme (various salts of divalent or trivalent iron). Non-heme iron is found in plant foods, including pomegranates and apples. Non-heme iron is less absorbed than heme iron; only 5-10% of non-heme iron contained in foods can be absorbed in the intestine. In addition, the absorption of non-heme iron is significantly influenced by foods eaten at the same time. Heme iron is found in foods of animal origin (meat, eggs and fish); other foods have little effect on its absorption in the intestine; about 20-30% of the heme iron contained in food is absorbed by the intestines. Thus, to prevent anemia, it is better to eat lean red meat than apples and pomegranates.
Starting from the fourth month of pregnancy, you need to reduce the amount of sugar and easily digestible carbohydrates in your diet. In the second half of pregnancy, a woman should receive 400-500 grams of carbohydrates per day. All carbohydrates are divided into difficult and easily digestible. The restriction applies only to easily digestible carbohydrates (sugar, sweets, juices, fruits, buns) after 20 weeks of pregnancy. With a lack of hard-to-digest carbohydrates in the body, proteins are consumed as energy “fuel,” the body’s resistance decreases, and fetal development worsens. The optimal source of difficult-to-digest (the healthiest) carbohydrates is cereals. Buckwheat, millet, corn and oatmeal are very healthy: they contain iron, carbohydrates, vitamins and fiber, which, although it does not provide the body with energy, must be contained in food, as it creates a feeling of satiety and promotes normal intestinal function.
Vegetables and fruits are also a good source of fiber, in their whole form rather than in juice form. The attitude towards juices during pregnancy is twofold. Store-bought packages are only suitable for pampering yourself; you cannot count on any healing properties of such juices. These drinks contain a lot of sugar, so women with blood sugar problems should not drink them. Freshly prepared juices without added salt and sugar are beneficial, and even such juices should not be drunk more than a glass a day. It is better to dilute freshly squeezed juices with water 1:1. This dilution is necessary due to the fact that juices are a very aggressive environment for the stomach; they can provoke heartburn. You need to choose juices with an eye on the region in which you live (a country apple is healthier than an imported orange). If you are allergic to any vegetables or fruits, juices from them are strictly prohibited.
Fats are also necessary for the development of the fetus; they should not be excluded from the diet. In addition to being the main source of energy in the body, they contain polyunsaturated fatty acids, which can affect the activity of the cardiovascular system, intestinal smooth muscles, female organs, and also help improve labor during labor. In addition, vegetable oils contain tocopherol (vitamin E), a deficiency of which can result in spontaneous abortion. Also an excellent source of fat is butter, sour cream and full-fat cottage cheese.
Third trimester.
In the third trimester of pregnancy, the fetus grows rapidly, the organs of the woman’s gastrointestinal tract are compressed, the load on organs and systems increases, so nutrition needs to be rearranged. It is advisable to take food 5-6 times a day, the last meal should be no later than 2-3 hours before bedtime. Chew your food thoroughly, slowly, without rushing: this is the only way it will be well absorbed and bring greater satiety. Meat and fish dishes should be consumed in the first half of the day, dairy - in the second, this is due to the fact that meat and fish dishes are digested more slowly. You should give up meat and fish broths, replacing them with vegetable and milk soups; they contain too much fat and extractives.
It is strictly forbidden to overeat and eat a lot at night: this will not only negatively affect the well-being of the woman herself, but will also significantly complicate the course of childbirth. Increased formation of adipose tissue in a woman can weaken labor. The baby is born large (more than 4 kg), which makes the normal course of labor difficult; moreover, the large mass of the child does not indicate his health. Large children after birth adapt less well to their new environment outside the mother’s body.
Many children's doctors are inclined to believe that the basis of nutrition for pregnant women and young children should be products that grow in the region where the family lives. It is to these products that our enzyme systems that digest food are adapted; these products are less likely to cause allergies. In the last 10 weeks of pregnancy, it is necessary to exclude foods that are strong allergens (chocolate, cocoa, coffee, nuts, citrus fruits, strawberries, wild strawberries, mushrooms). Such a restriction can reduce the risk of allergies in the unborn baby.
In the third trimester, we pay special attention to water-salt metabolism. Salt consumption in the last two months should be reduced to 5-6 g. It is salt that causes fluid retention in the body, swelling and a feeling of thirst. Fluid retention can cause kidney failure and, as a result, eclampsia (a severe form of late toxicosis of pregnancy, accompanied by convulsions, increased blood pressure and edema). Moreover, it is necessary not only to limit salt in the form of white powder, but also to exclude from the diet foods that contain a lot of salt: pickles, marinades, sausage (especially smoked), all canned food and hard cheese. Do not be afraid to leave your body completely without salt - it is included in bread, vegetables, meat - in its natural form. If you think foods without salt are completely tasteless, try a little trick. You can make the taste of salads, soups, meat and fish dishes very expressive and attractive by adding green onions, parsley and celery, dill, fresh tomatoes, cumin, garlic, lemon juice, marjoram, and leeks.
If pure water is pumped, then special restrictions are usually not required. If a pregnant woman strictly observes the salt limit, then she will want to drink much less; it will be enough to simply shift the balance towards the bound liquid - i.e. eat juicy foods, fruits, vegetables. The bound liquid in whole fruits does not go into edema, but remains in the blood, the peel of these whole fruits will help with stool, and the vitamin benefits are also obvious. To quench your thirst, it is better to use not very sweet fruits (apples, plums), as well as wild berries (sweets also increase thirst, like salt). If, while following the recommendations for limiting salt, swelling increases, then it is necessary to keep a “drunk-excreted” diary. The diary records all the liquid consumed for several days (drinked in milliliters, eaten in the form of vegetables and fruits in grams), as well as excreted during urination (in milliliters, measured with a measuring cup). When keeping such a diary, it becomes clear which foods retain more fluid in the body (based on the results of the day) - and such foods will have to be limited or excluded.
Pregnant women with increased or uneven weight gain, a tendency to edema, and late toxicosis of pregnancy (preeclampsia) in the third trimester may be prescribed fasting days (rice, curd, apple, fermented milk). You can arrange fasting days 1-2 times a week as prescribed by a doctor, preferably on the same days of the week, then the body will already be adjusted to unloading in advance. If the frequency of fasting days is once a week, it is preferable to fast on Monday, since diet violations are inevitable on weekends. Compensate for insufficient calories with sleep. On fasting days, sleep duration should be at least 9 hours. If you have an irresistible feeling of hunger, it is recommended to drink a glass of low-fat yogurt or kefir.
It is impossible to live 9 months without once violating dietary recommendations. The expectant mother, within reasonable limits, simply needs to pamper herself with what she really wants. For example, if you really want chocolate, be sure that a piece of the treasured chocolate once a week will not harm anyone. The positive emotions you get from your favorite food will reflect well on you and your baby. Indulge your desires, but try to do it infrequently and within reasonable limits.
Ekaterina Svirskaya
Obstetrician-gynecologist, 1st City Clinical Hospital, Minsk